CN113040973A - Integrated artificial blood vessel with stent and use method thereof - Google Patents

Abstract

The invention discloses an integrated artificial blood vessel with a stent and a use method thereof in a Stanford A-type aortic dissection operation, relating to the field of medical appliances. The integrated artificial blood vessel with the bracket has the total length of 250mm and is made of terylene artificial blood vessel. Comprises a dacron artificial blood vessel with a branch at the proximal part, and the length is 100 mm; the surface of the distal part is a terylene artificial blood vessel, the interior is a self-expanding W-shaped metal stent, the back side surface of the proximal end of the distal part is provided with a V-shaped opening structure, the fixing mode is suture, and the length is 150 mm. The two parts are connected by a metal ring, and the fixing mode is sewing. The effective length of the V-shaped structure is 40-70mm, the inner diameter of the integrated artificial blood vessel with the stent is 26-32mm, and the corresponding model is selected for use according to the measurement result in the operation. The invention can reserve the important blood vessel anatomical structure, reduce the number of operation cuts and anastomotic stoma, avoid the cooling process, shorten the time of stopping circulation and extracorporeal circulation, thereby reducing the operation difficulty and being easy to master.

Description

Integrated artificial blood vessel with stent and use method thereof

Technical Field

The invention relates to an artificial blood vessel, in particular to an integrated artificial blood vessel with a bracket, which is applied to Stanford A-type aortic dissection surgery and belongs to the field of medical appliances.

Background

Aortic dissection is a disease occurring in the major aortic vessels of the human body and belongs to the critical condition of cardiovascular surgery. The disease is acute in onset and severe in pain, and is often accompanied by serious complications such as transient consciousness loss, acute cardiac insufficiency, acute myocardial ischemia, intestinal ischemia, renal ischemia, lower limb ischemia and the like. According to incomplete statistics, the disease incidence rate is 0.5% -1% per year, and about 70% of patients die from aortic vessel rupture caused by aortic dissection or pericardial tamponade, sepsis, irreversible severe acid-base imbalance and electrolyte metabolic disorder caused by the severe complication within 2 weeks after the disease.

Hypertension and abnormal vessel wall development can cause rupture of aortic intima, and high-speed blood flow enters and tears the inner layer and the middle layer of the vessel wall through intima lacerations, so that an aortic interlayer is formed. The vascular tear may involve the entire course of the aortic root, ascending aorta, aortic arch, descending aorta and their branches, wherein the involvement or absence of the ascending aorta is closely related to the prognosis of the disease. The Stanford university named the aortic dissection with lesions affecting the ascending aorta as Stanford type A aortic dissection. The criticality of this type of aortic dissection is the highest of all aortic dissection diseases. Because the disease condition progresses fiercely, the death rate per hour is increased by 1% within the first 24 hours after the disease occurs; as untreated, 50% of patients die within 1 week of morbidity and 90% die within 1 year of morbidity. Thus, surgical treatment can save a patient's life as soon as diagnosis is confirmed. The currently more common surgical procedure for the treatment of Stanford type a aortic dissections is ascending aorta replacement + total aortic arch replacement + stenting rhinoplasty (fig. 1). The method can effectively reduce the fatality rate of the disease, and simultaneously has some problems:

the surgical incision is many: all surgical methods for treating the Stanford A-type aortic dissection at home and abroad, including the surgical method, adopt sternal median incision, axillary artery incision and femoral artery incision approaches, and are respectively used for exposing a surgical site, an axillary artery cannula and a femoral artery cannula, and the longest total of the three surgical incisions is 40 cm. The overlong operation incision brings higher risks of operation complications such as incision infection, poor healing, fat liquefaction, secondary suture and the like, the pain of a patient is aggravated, and unnecessary medical resource investment is increased.

The number of anastomotic stoma is large: the implementation of the ascending aorta replacement, the total aortic arch replacement and the bracket elephantiasis requires that the bracket elephantiasis is arranged in the descending aorta which is far away from the left subclavian artery, and the far end of the artificial blood vessel is matched with the descending aorta (9); then the three branches of the artificial blood vessel are respectively anastomosed with the three branches of the aortic arch of the self body (6, 7 and 8); finally, the proximal end of the artificial blood vessel is anastomosed with the aortic sinus junction (5). 5 blood vessels need to be anastomosed in the whole operation process, wherein 1 (9) anastomotic part is deeper, the anastomosis difficulty is high, and the hemostasis is difficult. The operation process is complex, the requirement on the operation technique of an operator is high, and a learning curve exists. More anastomotic stoma quantities are associated with higher bleeding risks, poor vascular anastomosis techniques often result in massive or even uncontrollable bleeding, significantly extending the time of the surgery, consuming large amounts of blood products, and in severe cases can lead to the possibility of neurological complications and even death of the patient.

Long extracorporeal circulation time: the operation needs to be performed under extracorporeal circulation, and the currently adopted extracorporeal circulation strategy is the straightforward cerebral perfusion during axillary and femoral artery perfusion and deep hypothermia stopping circulation. The problems brought by the axillary artery and femoral artery intubation are the increase of surgical incision, poor perfusion of the limb at the far end of the intubation, narrow anastomotic stoma, thrombus and the like. The deep hypothermia is stopped when the aortic arch part is replaced, and the problems that the operation time is prolonged due to the slow temperature rise and decrease process, the blood coagulation function is influenced due to the long-term low-temperature state of the organism, and a large amount of inflammatory factors are generated are brought.

Disclosure of Invention

In order to solve the problems, the invention provides an integrated stented artificial blood vessel for treating a Stanford A-type aortic dissection and a using method in operation, and aims to provide a new surgical treatment strategy which can reduce operation difficulty, reduce the number of operation cuts and anastomotic orifices, avoid a cooling process and shorten the time of stopping circulation and extracorporeal circulation while ensuring the treatment effect.

In order to achieve the purpose, the integrated artificial blood vessel with the stent provided by the invention is prepared by the following steps:

the integrated artificial blood vessel with the bracket has the total length of 250mm and is made of terylene artificial blood vessel. Comprises a dacron artificial blood vessel with a single branch at the proximal part, the length of the dacron artificial blood vessel is 100mm, the length of a branch blood vessel on the dacron artificial blood vessel is 80mm, the inner diameter of the branch blood vessel is 10mm, and the distance between an opening and the proximal end is 70 mm; the surface of the distal part is a dacron artificial blood vessel, the interior of the distal part is a self-expanding W-shaped titanium-nickel alloy metal stent, the back side surface of the proximal end of the distal part is provided with a V-shaped opening structure, the fixing mode is suture, and the length is 150 mm. When the distal part is not released, the proximal end of the W-shaped titanium-nickel alloy metal stent is 10mm and supported on the inner wall of the metal ring in an opening state; the artificial blood vessel part with the bracket and a V-shaped opening structure gradually contracts from near to far; the rest of the artificial blood vessel with the stent is in a maximum contraction state. The distal end portion is bound to the guide wire and the arc-shaped guide frame by a wire. The two parts are connected by a titanium-nickel alloy metal ring, and the fixing mode is sewing. The opening width of the V-shaped structure is 15mm, the effective length is 40-70mm, and the inner diameter of the integrated artificial blood vessel with the stent is 26-32 mm. The models of the artificial blood vessels with the integrated stents can be selected for use according to the measurement result in the operation.

The V-shaped structure is a naked region covered by the artificial blood vessel without the stent, wherein two sides of the naked region are parallel and then intersect at a vertex (included angle of 60 degrees), and the openings of the innominate artery, the left common carotid artery and the left subclavian artery are positioned in the naked region after the naked region is accurately released in the operation.

The width of the opening of the V-shaped structure specifically refers to the distance between two parallel edges, and is 15 mm.

The effective length of the V-shaped structure specifically refers to the running distance of two parallel sides, and the distances from the proximal end of the innominate artery opening to the distal end of the left subclavian artery opening are respectively 40mm, 50mm, 60mm and 70 mm.

The bare area provided by the V-shaped structure is 697.5mm respectively²、847.5mm²、997.5mm²、1147.5mm²。

When the distal part of the integrated artificial blood vessel with the stent is not released, the proximal end of the W-shaped titanium-nickel alloy metal stent with the length of 10mm is supported on the inner wall of the metal ring in an expanded state, and the shrinkage rate of the stent is 0.

When the distal part of the integrated artificial blood vessel with the stent is not released, the artificial blood vessel part with the stent and the V-shaped opening structure gradually contracts from near to far, and the stent contraction rate gradually increases from 0 to 66.7 percent.

When the distal part of the integrated artificial blood vessel with the stent is not released, the artificial blood vessel with the stent without the V-shaped opening structure is in the maximum contraction state, and the stent contraction rate is 66.7%.

When the distal part of the integrated artificial blood vessel with the bracket is not released, the integrated artificial blood vessel with the bracket is bound on the guide steel wire and the arc-shaped guide frame by adopting a wire.

The titanium-nickel alloy metal ring is characterized in that: the width of the metal ring is 10mm, the two sides of the metal ring are provided with sewing rings with the width of 3mm, the outer surface of the metal ring is provided with an annular groove with the width of 4mm and the depth of 2mm, and the inner diameter of the metal ring is the same as that of the integrated artificial blood vessel with the bracket.

The titanium-nickel alloy metal ring is characterized in that: the top of the external surface of the back side of the device is provided with a large arrow, and the two sides of the device are respectively provided with a small arrow at the position of 7.5mm for releasing the front positioning.

The diameters of the integrated artificial blood vessel with the bracket are respectively 26mm, 28mm, 30mm and 32 mm.

The integrated artificial blood vessel with the stent has 16 models, specifically 40 × 26mm, 40 × 28mm, 40 × 30mm, 40 × 32mm, 50 × 26mm, 50 × 28mm, 50 × 30mm, 50 × 32mm, 60 × 26mm, 70 × 30mm, and 70 × 32 mm.

An application method of an integrated artificial blood vessel with a stent in Stanford A type aortic dissection.

The operation of the distal part of the integrated artificial blood vessel with the support is carried out, the ascending aorta is transversely crossed at a position 10mm away from the proximal end of the root of the innominate artery, the distance from the proximal end of the opening of the innominate artery to the distal end of the opening of the left subclavian artery and the inner diameter of an aortic arch are measured by using a measurer, the model of the integrated artificial blood vessel with the support is selected according to the measurement result, the distal part of the integrated artificial blood vessel with the support is placed into the descending aorta from the true cavity of the aortic arch through the transverse ascending aorta, a metal ring is placed at a position 5mm away from the proximal end of the root of the innominate artery, a big arrow is aligned to the proximal end of the root of the innominate artery during positioning, the two corresponding small arrows are respectively positioned at the outer sides of the ventral end point and the dorsal end point of the root of the innominate, The left common carotid artery opening and the left subclavian artery opening are positioned in a bare area covered by the artificial blood vessel without the stent provided by the V-shaped structure, and the autologous aortic wall around the metal ring is firmly fixed in the metal ring groove by using the disposable sterilizing and rolling band. The partial operation is equivalent to that the aortic arch replacement and the bracket elephantiasis are completed at one time, and the operation time is 5-10 minutes.

The operation of the integrated artificial blood vessel proximal part with the stent is carried out, after the root blocking belt of the innominate artery is removed and the air is fully exhausted, the artificial blood vessel is blocked at the position 30mm away from the proximal end of the root of the branch blood vessel, the arterial cannula is arranged through the branch blood vessel and is fixed for perfusion, the proximal end of the artificial blood vessel is trimmed, and the anastomosis with the junction of the sinus canal of the autologous aorta is completed. Equivalent to the completion of the ascending aorta replacement, only 1 anastomotic stoma exists in the whole operation process.

The integrated artificial blood vessel with the stent is used by adopting an extracorporeal circulation strategy, the root parts of the innominate artery and the left common carotid artery are provided with blocking belts for standby application, a bidirectional perfusion right-angle artery cannula (irrelevant to the invention) is used for cannula perfusion in the innominate artery, the right atrial venous cannula is used for drainage to establish extracorporeal circulation, the ascending aorta is blocked at normal temperature, the ascending aorta is longitudinally cut, myocardial protective liquid is perfused through the coronary artery opening under direct vision, after the heart is arrested, the innominate artery root blocking belts are tightened to block the innominate artery opening, and perfusion blood flows to the right common carotid artery through the second hole of the bidirectional perfusion right-angle artery cannula, namely, the whole body is arrested and the unilateral antegrade brain perfusion is carried out. And opening the unknown artery root blocking belt after the operation of the distal part of the integrated artificial blood vessel with the stent is completed, and perfusing blood flows through the first hole and the second hole of the arterial cannula to perfuse and recover circulation. After sufficient exhaust, the proximal end of the artificial blood vessel is blocked, an arterial cannula is placed through the branch of the artificial blood vessel for perfusion, and perfusion through innominate arteries is blocked at the same time. The blocking forceps are opened after the proximal anastomosis and the air exhaust are completed.

The invention adopts an integrated structure which combines an artificial blood vessel with a bracket and a single-branch artificial blood vessel with a V-shaped opening structure into a whole, and the invention can obtain the following beneficial effects when being applied to the surgical operation of the Stanford A type aortic dissection:

1. the number of anastomotic stoma is reduced: the integrated artificial blood vessel with the bracket is applied to the Stanford A-type aortic dissection, so that the artificial blood vessel does not need to be anastomosed with descending aorta, innominate artery, left common carotid artery and left subclavian artery respectively like the existing operation mode, the number of anastomotic stoma of the existing operation mode can be reduced from 5 to 1, the operation steps are simplified to a great extent, the operation difficulty is reduced, and the operation is easy to master. Meanwhile, the bleeding risk can be obviously reduced, so that the consumption of suture and blood products generated in the long hemostasis process is reduced.

2. The number of surgical incisions is reduced: compared with the extracorporeal circulation strategy used in the existing Stanford A-type aortic dissection surgical operation, the extracorporeal circulation strategy adopted by the integrated stented artificial blood vessel in the operation does not comprise perfusion through the axillary artery and the femoral artery, so the incision of the axillary artery and the femoral artery is not needed, and the number of the operation incisions in the existing operation mode can be reduced from 3 to 1.

3. Avoiding long-time cooling and cycle stopping processes: due to the particularity of aortic arch position, the long time consuming traditional aortic arch replacement process, it is conventional to stop the blood supply to organs of the whole body except the brain and reduce the central temperature below 28 ℃ to reduce the metabolic rate of the body to provide longer vascular anastomosis time. The invention is applied in the operation, the measurement, the positioning, the release and the fixation are completed from the root blockage of the innominate artery, and the total time of the blockage removal can be controlled within 10 minutes. The operation can be carried out at normal temperature, the temperature changing process is omitted, the circulation stopping time, the extracorporeal circulation time and the operation time are obviously shortened, and the adverse effects of low temperature and extracorporeal circulation on the body are reduced.

4. The original anatomical structure is kept: the integrated artificial blood vessel with the bracket designed by the invention has a structure with a V-shaped opening, and can provide a bare area covered by the artificial blood vessel without the bracket so that the opening of the arch part branch blood vessel is positioned in the bare area, so that reconstruction of the arch part branch blood vessel is not needed like the traditional operation method, the original anatomical structure structures of the three important blood vessels for supplying blood to the head, the face and the upper limbs are reserved, and the long-term effect of the operation is improved.

Drawings

FIG. 1 is a schematic view of the anatomy of a blood vessel after completion of a prior art surgical procedure;

FIG. 2 is a schematic view of the anatomical structure of the integrated stented artificial blood vessel in use;

FIG. 3 is a front view of the integrated stented vascular prosthesis of the present invention after release;

FIG. 4 is a top view of the vascular prosthesis of FIG. 3;

FIG. 5 is a front view of the integrated stented prosthetic vessel of the present invention shown unreleased;

FIG. 6 is a top view of the vascular prosthesis of FIG. 5;

description of reference numerals: 1-integral stent-equipped artificial blood vessel proximal part; 101-branch artificial blood vessel; 102-a branch artificial vessel opening; 2-integral artificial blood vessel distal part with bracket; 201-V-shaped open structure without stent and artificial vessel covering; 202-terylene artificial blood vessel; 203- "W" shaped self-expanding stent; 3-a metal ring; 301-large white arrow; 302-small white arrow; 303-a sewing ring; 304-a groove; 4-guiding the steel wire; 5-artificial blood vessel proximal anastomosis; 6-anastomosing stoma of branch of artificial blood vessel and innominate artery; 7-anastomotic stoma of one branch of the artificial blood vessel and the left common carotid artery; 8-anastomotic stoma of one branch of the artificial blood vessel and the left subclavian artery; 9-artificial blood vessel distal anastomosis; 10-binding and rolling the belt at one time; 11-branch artificial blood vessel that has been sutured.

Detailed Description

The present invention and the method of using the same will be described in detail with reference to fig. 2 to 6, using a Stanford a-type aortic dissection lesion with a distance from the proximal end of the innominate artery to the distal end of the left subclavian artery and an aortic arch inner diameter of 30mm, and using an integrated stented artificial blood vessel with a model of 50 x 30mm as an example 1.

The integrated artificial blood vessel with the bracket has the total length of 250mm and is made of terylene artificial blood vessel.

The proximal part is a dacron artificial blood vessel 1 with single branch. The length of the artificial blood vessel is 100mm, the proximal end can adopt a wedge-shaped excision mode to be matched with the inner diameter of the junction of the sinus canal of the self-body aorta, and the artificial blood vessel can be excised to a proper length in an oblique manner. Thebranch blood vessel 101 is 80mm in length and 10mm in inner diameter, and is mainly used for being implanted with an arterial cannula to participate in extracorporeal circulation, and the root of the branch blood vessel is sutured 11 after the extracorporeal circulation is finished.

The distal part is a stentedartificial blood vessel 2 with a V-shaped opening at the proximal end. The outer surface is a dacronartificial blood vessel 202, the interior is a self-expanding W-shaped titanium-nickelalloy metal stent 203, the back side surface of the near end is provided with a V-shapedopening structure 201, the fixing mode is suture, and the length is 150 mm.

In the released state, the "V" shapedopening structure 201 is specifically a bare area covered by the stentless artificial blood vessel with two parallel sides and then intersecting at the vertex (included angle of 60 °), and is intended to expose openings of the innominate artery, the left common carotid artery and the left subclavian artery. The total length of the area refers to the linear distance between the middle point of a connecting line of two end points at the proximal end of the V-shaped opening and the end point of the connecting line, the effective length refers to the running distance of the parallel section, and the width refers to the distance between the two parallel lines, which is 15 mm.

The two parts are connected by a titanium-nickelalloy metal ring 3 with suture rings on both sides, and the distal end of the proximal part and the proximal end of the distal part are respectively pre-sutured on the suture rings 303. The width of the metal ring is 10mm, the width of the suture ring is 3mm, and the inner diameter of the suture ring is the same as that of the integrated artificial blood vessel with the bracket. The outer surface is provided with anannular groove 304 with the width of 4mm and the depth of 2mm, and the disposable bundling and rolling belt 10 is used for fixing the autologous aortic wall in the groove. A whitelarge arrow 301 is arranged at the top of the outer surface of the back side of the metal ring and points to the central axis of the V-shaped opening structure; a smallwhite arrow 302 is arranged at the position 7.5mm away from the two sides of the large arrow and used for positioning before the stent is released.

When the positioning is carried out, the large arrow points are aligned to the proximal end point of the root of the innominate artery, and the two corresponding small arrow points are respectively positioned at the outer sides of the ventral end point and the dorsal end point of the root of the innominate artery and are oriented to be vertical to the connecting line of the two points, namely, the central line of the V-shaped opening structure is coaxial with the connecting line of the openings of the innominate artery, the left common carotid artery and the left subclavian artery on the frontal axis.

When the distal part of the integrated artificial blood vessel with the stent is not released (fig. 5 and 6), the proximal end of the W-shaped titanium-nickel alloy metal stent is supported on the inner wall of the metal ring in an expanded state with the length of 10mm, and the shrinkage rate of the stent is 0; the artificial blood vessel part with the bracket and a V-shaped opening structure is in a gradually contracted state from near to far, and the contraction rate of the bracket is gradually increased from 0 to 66.7 percent; the rest of the artificial blood vessel with the stent is in a maximum contraction state, and the contraction rate of the stent is 66.7 percent.

The distal part of the integrated artificial blood vessel with the bracket is bound on theguide steel wire 4 and the arc-shaped guide bracket by adopting a wire.

When the distal part of the integrated artificial blood vessel with the stent is released, the silk thread is drawn out through theguide steel wire 4, and then the distal part of the integrated artificial blood vessel with the stent can be released from near to far.

The method for using the integrated stented artificial blood vessel in the Stanford A type aortic dissection surgery comprises the following steps: the root of the innominate artery and the left common carotid artery is provided with a blocking belt for standby application, a bidirectional perfusion right-angle artery cannula is used for cannula perfusion in the innominate artery, the right atrial venous cannula is used for drainage to establish extracorporeal circulation, the ascending aorta is blocked at normal temperature, the ascending aorta is longitudinally cut, myocardial protective solution is perfused through the coronary artery opening under direct vision, and ice debris is placed on the surface of the heart. After the heart stops beating, the root blocking belt of the innominate artery is tightened to block the opening of the innominate artery, and the perfusion blood flows to the right common carotid artery through the second hole of the bidirectional perfusion right-angle artery cannula, namely, unilateral antegrade cerebral perfusion is performed. The ascending aorta is intersected at the position 10mm away from the proximal end of the root of the innominate artery, and an integrated artificial blood vessel with a stent is selected from the model of 50 x 30 mm. The distal part of the integrated artificial blood vessel with the support is placed into a descending aorta from an aortic arch part true cavity through a transverse ascending aorta, a metal ring is placed at the position 5mm away from the proximal end of the root of the innominate artery, a large arrow is aligned to the proximal end point of the root of the innominate artery during positioning, two corresponding small arrows are confirmed to be respectively positioned at the outer sides of the ventral end point and the dorsal end point of the root of the innominate artery and point to be perpendicular to a connecting line of two points, the artificial blood vessel with the support is released after being confirmed to be correct, the artificial blood vessel with the support is visually confirmed to be fully expanded to be attached to the wall after being released, and the opening of the innominate artery, the opening of the left common. The disposable sterilized band 10 is used to fix the autologous aortic wall around the metal ring to the metal ring. The blocking belt at the root of the innominate artery is opened, and the perfusion blood flows through the first hole and the second hole of the arterial cannula to restore the whole blood supply. After the innominate artery is opened and fully exhausted, the artificial blood vessel is blocked at the position 30mm away from the proximal end of the root of the collateral blood vessel, the arterial cannula is placed in the collateral blood vessel and is fixed for perfusion, and the arterial cannula on the innominate artery is blocked and removed. And (4) obliquely cutting off the overlong artificial blood vessel to finishanastomosis 4 of the proximal end of the integrated artificial blood vessel with the stent and the junction of the aortic sinus vessel. After the extracorporeal circulation is completed, the arterial cannula is removed and thebranch vessel 11 is sutured.

Example 2:

the invention can be applied to Stanford A type aortic dissection lesion with the distance from the proximal end of the innominate artery opening to the distal end of the left subclavian artery opening of 70mm and the inner diameter of the aortic arch of 32mm to the maximum extent, and the invention selects an integrated stented artificial blood vessel with the model of 70 x 32mm, and the rest is the same as the embodiment 1.

Example 3:

the invention can be applied to Stanford A type aortic dissection lesion with the distance from the proximal end of the innominate artery opening to the distal end of the left subclavian artery opening of 40mm and the inner diameter of the aortic arch of 26mm at the minimum, selects an integrated artificial blood vessel with a stent of 40 x 26mm type, and has the same other types as the embodiment 1.

The above-described embodiments are not intended to limit the present invention, and various modifications and changes may be made to the present invention by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (10)

1. An integrated stented artificial blood vessel, comprising: the total length is 250mm, the material is a terylene artificial blood vessel, the terylene artificial blood vessel comprises a terylene artificial blood vessel with a single branch blood vessel at the proximal part, the length is 100mm, the length of the branch blood vessel on the terylene artificial blood vessel is 80mm, the inner diameter is 10mm, and the opening distance is 70mm from the proximal end; the surface of the distal part is a dacron artificial blood vessel, the interior of the distal part is a self-expanding W-shaped titanium-nickel alloy metal stent, the back side surface of the proximal end of the distal part is provided with a V-shaped opening structure, the fixing mode is suture, and the length is 150 mm; when the distal part is not released, the proximal 10mm of the W-shaped titanium-nickel alloy metal stent is supported on the inner wall of the metal ring in an open state, the part of the artificial blood vessel with the stent, which is provided with a V-shaped opening structure, is in a gradually contracted state from near to far, the rest part of the artificial blood vessel with the stent is in a maximum contracted state, and the distal part is bound on the guide steel wire and the arc-shaped guide frame by adopting a wire; the two parts are connected by a titanium-nickel alloy metal ring, and the fixing mode is sewing; the opening width of the V-shaped structure is 15mm, the effective length is 40-70mm, the inner diameter of the integrated artificial blood vessel with the stent is 26-32mm, and the model of the integrated artificial blood vessel with the stent is selected according to the measurement result in the operation for use.

2. The integrated stented artificial blood vessel of claim 1, wherein: the V-shaped structure is a bare area covered by the artificial blood vessel without the stent, wherein two sides of the bare area are parallel and then intersect at a vertex (included angle of 60 degrees), and the effective lengths of the bare area are respectively 40mm, 50mm, 60mm and 70 mm.

3. The integrated stented artificial blood vessel of claim 1, wherein: when the distal part is not released, the proximal end 10mm of the W-shaped titanium-nickel alloy metal stent is supported on the inner wall of the metal ring in an expanded state, and the stent shrinkage rate is 0; the artificial blood vessel part with the bracket and a V-shaped opening structure is in a gradually contracted state from near to far, and the contraction rate of the bracket is gradually increased from 0 to 66.7 percent; the artificial blood vessel part without the V-shaped opening structure with the stent is in the maximum contraction state, and the contraction rate of the stent is 66.7 percent.

4. The integrated stented artificial blood vessel of claim 1, wherein: the distal part is bound on the guide steel wire and the arc-shaped guide frame by adopting a wire, and when the artificial blood vessel with the integrated stent is used, the wire is drawn out through the guide steel wire, so that the distal part of the artificial blood vessel with the integrated stent can be released from near to far.

5. The integrated stented artificial blood vessel of claim 1, wherein: the titanium-nickel alloy metal ring is 10mm wide, two sides of the metal ring are provided with sewing rings with the width of 3mm, the outer surface of the metal ring is provided with an annular groove with the width of 4mm and the depth of 2mm, and the inner diameter of the metal ring is the same as that of the integrated artificial blood vessel with the bracket; the top of the back side of the outer surface of the bag is provided with a large arrow, and the two sides of the bag are respectively provided with a small arrow at the position with the horizontal distance of 7.5 mm.

6. The integrated stented artificial blood vessel of claim 1, wherein: the inner diameter of the integrated artificial blood vessel with the stent is 26-32mm, and specifically comprises the following components: 26mm, 28mm, 30mm, 32 mm.

7. The integrated stented artificial blood vessel of claim 1, wherein: the integrated artificial blood vessel with the stent has 16 models, specifically 40 × 26mm, 40 × 28mm, 40 × 30mm, 40 × 32mm, 50 × 26mm, 50 × 28mm, 50 × 30mm, 50 × 32mm, 60 × 26mm, 70 × 30mm, and 70 × 32 mm.

8. An application method of an integrated artificial blood vessel with a stent in Stanford A type aortic dissection.

9. The use of the integrated stented prosthesis of claim 8 in a Stanford type A aortic dissection procedure, wherein: the distal part of the integrated artificial blood vessel with the stent is operated, the ascending aorta is transversely intersected at a position 10mm away from the proximal end of the root of the innominate artery, the distance from the proximal end of the opening of the innominate artery to the distal end of the opening of the lower left subclavian artery and the inner diameter of an aortic arch are measured by using a measurer, the model of the integrated artificial blood vessel with the stent is selected according to the measurement result, the distal part of the integrated artificial blood vessel with the stent is placed into the descending aorta from the true cavity of the aortic arch through the transverse ascending aorta, a metal ring is placed at a position 5mm away from the proximal end of the root of the innominate artery, a big arrow is aligned to the proximal end of the root of the innominate artery during positioning, two corresponding small arrows are respectively positioned at the outer sides of the ventral end point and the dorsal end of the root of the innominate artery and are directed to be perpendicular, The opening of the left subclavian artery is positioned in the opening of the V-shaped structure, and the one-time sterilizing and rolling band is used for firmly fixing the autologous aorta wall around the metal ring in the metal ring groove; the operation of the integrated proximal part of the artificial blood vessel with the stent is carried out, after the innominate artery is opened and the air is fully exhausted, the artificial blood vessel is blocked at the position 30mm away from the proximal end of the root part of the collateral branch blood vessel, the arterial cannula is arranged in the collateral branch blood vessel and is fixed for perfusion, the proximal end of the artificial blood vessel is trimmed, and the anastomosis with the junction of the autologous aortic sinus vessel is completed.

10. The use of the integrated stented prosthesis of claim 8 in a Stanford type A aortic dissection procedure, wherein: the integrated artificial blood vessel with the bracket needs to be matched with an extracorporeal circulation method in the using process, the root parts of a innominate artery and a left common carotid artery are provided with blocking belts for standby, a bidirectional perfusion right-angle artery cannula is used for cannula perfusion in the innominate artery, the right atrial venous cannula is used for drainage to establish extracorporeal circulation, the ascending aorta is blocked at normal temperature, the ascending aorta is longitudinally cut, a myocardial protective solution is perfused through a coronary artery opening under direct vision, after the heart stops beating, the innominate artery root blocking belt is tightened to block the innominate artery opening, perfused blood flows to the right common carotid artery through a second hole of the bidirectional perfusion right-angle artery cannula, the whole body stops circulation and unilateral antegrade cerebral perfusion is carried out, the root blocking belts of the innominate artery are opened after the operation of the distal part of the integrated artificial blood vessel with the bracket is completed, the perfused blood flows through a first hole and a second hole of the arterial cannula to, the artificial blood vessel branch is inserted into the artery cannula for perfusion, and the perfusion through the innominate artery is blocked, so that the proximal anastomosis is completed, and the blocking forceps are opened after the air is exhausted.

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